Surgical Strategy for Sporadic Primary Hyperparathyroidism an Evidence-based Approach to Surgical Strategy, Patient Selection, Surgical Access, and Reoperations

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2009 Jun 26

PMID 19554347

Citations 31

Authors

Radu Mihai

Marcin Barczynski

Maurizio Iacobone

Antonio Sitges-Serra

Affiliations

Soon will be listed here.

Abstract

Purpose: Progress in parathyroid imaging has brought substantial changes in the surgical strategy to approach patients with sporadic primary hyperparathyroidism (pHPT). The present review is focused on the safety and efficacy of limited parathyroid exploration.

Materials And Methods: Review of the literature focused on studies dealing with unilateral (two-gland exploration) or selective parathyroidectomy (one-gland exploration) in selected patients with pHPT and on the classification of published reports according to the degree of evidence.

Results: Parathyroid exploration limited to a solitary parathyroid adenoma can be considered a minimally invasive procedure that can be performed by the minicervicotomy, video-assisted, or endoscopic approaches. In properly selected patients, it affords results comparable to those of four-gland bilateral exploration in terms of cure and recurrence. It causes less postoperative hypocalcemia.

Conclusions: Selective parathyroidectomy is an option for patients with positive preoperative localization tests undergoing first-time surgery who have no family history of pHPT, no goiter for which surgical therapy is proposed, and are not on lithium therapy.

Citing Articles

Operative management of primary hyperparathyroidism in Europe.

Noren E, Nordenstrom E, Bergenfelz A BJS Open. 2024; 8(3).

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The Relationship of Negative Imaging Result and Surgical Success Rate in Primary Hyperparathyroidism.

Unlu M, Kostek M, Caliskan O, Sekban T, Aygun N, Uludag M Sisli Etfal Hastan Tıp Bul. 2023; 57(1):111-117.

PMID: 37064856 PMC: 10098394. DOI: 10.14744/SEMB.2023.09076.

Persistent and Recurrent Primary Hyperparathyroidism: Etiological Factors and Pre-Operative Evaluation.

Uludag M, Unlu M, Kostek M, Caliskan O, Aygun N, Isgor A Sisli Etfal Hastan Tıp Bul. 2023; 57(1):1-17.

PMID: 37064844 PMC: 10098391. DOI: 10.14744/SEMB.2023.39260.

The Role of Bilateral Neck Exploration for Primary Hyperparathyroidism in the Minimally Invasive Parathyroidectomy Era.

Unlu M, Kostek M, Caliskan O, Aygun N, Uludag M Sisli Etfal Hastan Tıp Bul. 2023; 56(4):489-496.

PMID: 36660393 PMC: 9833349. DOI: 10.14744/SEMB.2022.42492.

Evaluation of Wisconsin and CaPTHUS Indices Usefulness for Predicting Monoglandular and Multiglandular Disease in Patients with Primary Hyperparathyroidism through the Analysis of a Single-Center Experience.

De Pasquale L, Lori E, Bulfamante A, Felisati G, Castellani L, Saibene A Int J Endocrinol. 2021; 2021:2040284.

PMID: 34671396 PMC: 8523259. DOI: 10.1155/2021/2040284.

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